Fig. 3 Cardiac magnetic resonance with a myocarditis protocol. Spin-echo T1-weighted images show increased global early myocardial enhancement A) before and B) after gadolinium contrast, yielding an elevated ratio of 6.1 (normal, <4). C) Fast-spin-echo T2-weighted image shows global myocardial edema with an elevated ratio (2.1) of T2 signal in the myocardium compared to skeletal muscle (normal, <2). D) Late-gadolinium-enhancement image shows no focal myocardial fibrosis or injury.